Insurance Manager

**** **** *** 424-***-**** (cell)

Los Angeles, CA 323-***-****

***** (home)

323-***-**** (fax)

Nigritashaw@yahoo.

com

Nigrita Shaw

Experience 2007–2013 Aptium Oncology (Cedar Sinai) Los Angeles,

CA

Executive Assistant to Chief of Oncology Research

Creates and maintain positive patient relations and swift, accurate communications between the

Research Office, Health Information Department, patients, physicians and Directors office. High

degree of responsibility, decision-making, confidentiality and ability to act appropriately required

due to variety of potentially sensitive or delicate situations. Maintains Doctor’s schedule. Organize

and maintain administrative and operational files (paper & computer), meeting agendas, notes and

materials. Compose and/or edit formal correspondence, reports and publications from oral or

written transmitted notes or outlines using appropriate forms, syntax, grammar, style and spelling.

Provide consistent service/maintenance/back-up for Doctor’s office equipment to ensure continuous

operations, data preservation and security, and quick recovery in emergencies. Provide word-

processing, spreadsheet, database and graphics training and support for the Research Department

and others as designated by the Doctor. Maintains department staff meeting minutes. Extremely

high degree of confidentiality required. Rapid decision making, appropriate behavior and ability to

handle unforeseen, unexpected situations with professionalism required. Assists in preparations of

formal presentations including graphic presentations, overhead slides and presentations, research

and data compilation. Organize and maintain personnel folders and documentation. Responsible for

maintaining records in accordance with accreditation requirement. Prepare and process requisitions,

check requests and purchase orders, and manage inventory of operating supplies, equipment and

space. Maintains weekly distribution for supplies. Independently designs and implements special

projects and assignments within given time, resources, and contract frames assigned by Doctor and

Research Department. Participates in a program of continuing education and development of

improve skills related to assignment both personal and technical. Support Research Department in

$5 million operating budget. Extensive knowledge of Payroll, Epic, Kronos and Lawson, and

policies and procedures.

2003–2006 UCLA Santa Monica, CA

Office Manager / Ortho Surgery Coordinator

Manage Department of Orthopedic Surgery Clinic, Coordinate and schedule pre-op work up and

surgery for 19 orthopedic surgeons, also pre authorize all surgeries with insurance companies.

Prepare patient charts for clinic, obtain necessary documentation and insurance authorizations for

clinic visits and maintain all patient files. Correct, print and distribute transcribed patient notes as

directed by Department of Orthopedic Surgery physicians. Screen and direct all incoming calls.

Correspond with patients, third-party payers and professional as needed to confirm appointments,

and obtain and exchange necessary patient information. Send reports and other correspondence to

physicians, patients, and third-party payers. Provide appointment dates and times to patients in

accordance with established policies and procedures using the Medical Center ADT system.

2001–2003 Medtronic Minimed Northridge, CA

Insurance Collections Specialist

Make collection calls, process correspondence related to insurance companies and customers.

Accepting ownership for accomplishing new and different requests. knowledge of insurance plans

(PPO, EPO, HMO, etc.). Familiarity with EOB’s, ICD-9 and HCPC codes, insurance

correspondence and billing issues and referral, authorization process. Strong communication

abilities, solid computer skills and strength as a team player.

1997–2001 Blue Cross Woodland Hills, CA

Provider Relations

Responds to provider’s questions via telephone and written correspondence regarding insurance

benefits, provider contracts, eligibility and claims. Analyzes problems and provides

information/solutions. Operates a PC/image station to obtain and extract information; documents

information, activities and changes in the database. Thoroughly documents inquiry outcomes for

accurate tracking and analysis. Develops and maintains positive provider relations and coordinates

with various functions within the company to ensure provider requests and questions are handled

appropriately and in a timely manner. Researches and analyzes data to address operational

challenges and provider service issues. Provides external and internal providers with requested

information. Receives and places follow-up telephone calls / e-mails to answer customer questions

that are routine in nature. Uses computerized systems for tracking, information gathering and

troubleshooting. Requires knowledge of company services, products, insurance benefits, provider

contracts and claims. Seeks, understands and responds to the needs and expectations of internal and

external providers. Performs other duties as assigned

Education 1992–1996 Cheyney University Cheyney, PA

Major: Business Administration.

Skills

Microsoft Suite 2010

Reference: Available upon request.

Contact this candidate